Related Experiment Video
Updated: Jan 4, 2026
Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Parents' view of the cognitive outcome one year after pediatric epilepsy surgery
Christian Hoppe1, Izabela Porębska1, Kassandra Beeres1
1Department of Epileptology, University of Bonn Medical Centre, Venusberg-Campus 1, FRG-53127 Bonn, Germany.
Insights
Pediatric epilepsy surgery generally improves cognitive function, particularly in language and memory, as reported by parents. While seizure freedom and reduced medication are key, some children still face cognitive decline.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Epilepsy Surgery Outcomes
Background:
- Cognitive outcomes of pediatric epilepsy surgery are typically assessed using standardized tests.
- Parental perspectives offer a valuable, yet less explored, dimension of cognitive changes post-surgery.
Purpose of the Study:
- To analyze the cognitive outcomes of pediatric epilepsy surgery from the parents' perspective across six domains.
- To correlate parental ratings of cognitive function with objective neuropsychological assessments.
Main Methods:
- Parents of 96 pediatric epilepsy surgery patients completed the Kognitive Probleme bei Kindern und Jugendlichen (KOPKIJ) questionnaire preoperatively and 12 months postoperatively.
- Standardized neuropsychological assessments were also conducted at both time points.
- Analysis focused on changes in cognitive domains including language, memory, executive functions, attention, school, and visuospatial abilities.
Main Results:
- Parents reported significant postoperative improvements in five of six cognitive domains, with visuospatial abilities remaining unchanged.
- Eighty percent of patients achieved seizure freedom, and improvements in cognitive function were linked to seizure control and reduced antiseizure drug load.
- Despite overall positive trends, 35% of patients experienced a decline in at least one cognitive domain; parental ratings and neuropsychological scores did not correlate.
Conclusions:
- Pediatric epilepsy surgery is associated with positive neurocognitive development from a parental viewpoint, aligning with standardized test results.
- Seizure freedom and a lower antiseizure drug burden are critical factors for improved cognitive outcomes.
- A notable risk of cognitive decline exists, potentially impacting daily functioning, even with overall improvements.
Objectives:
The cognitive outcome of pediatric epilepsy surgery has mainly been examined on the basis of standardized tests. Here, we analyzed the outcome in six cognitive domains from the parents' view.
Methods:
Included were consecutive surgical pediatric patients whose parents filled-in a comprehensive questionnaire on cognitive problems in children and adolescents (Kognitive Probleme bei Kindern und Jugendlichen (KOPKIJ); Gleissner et al. 2006) at the preoperative baseline (T1) as well as twelve months thereafter (T2). All children also underwent standard neuropsychological assessments at T1 and T2.
Results:
Parents of 96 patients provided pre- and postoperative KOPKIJ data. Overall, 80% of the children became seizure-free at the follow-up. Group means indicated a strong positive effect of time on KOPKIJ and neuropsychological performance. We found postoperative improvements in five out of six cognitive domains (language, memory, executive functions, attention, school; unchanged: visuospatial abilities). Individually, improvements were twice as likely as declines. However, 33 patients (35%) experienced significant decline in at least one cognitive domain. Later onset of epilepsy resulted in better performance but had no effect on change scores. Seizure-free status, lower antiseizure drug load, and stronger drug reduction after surgery contributed to postoperative cognitive improvements as perceived by the parents; no other effects of clinical factors were obtained (e.g., localization/lateralization). Despite their similar outcome patterns, change scores as derived from parental ratings and neuropsychological assessment were not correlated.
Conclusions:
Parents acknowledged the overall positive neurocognitive development after pediatric epilepsy surgery as previously shown by standardized tests. Seizure freedom and lower antiseizure drug load contributed to the beneficial cognitive outcome. Even if cognitive improvements outweighed declines, a risk for cognitive decline with impact on everyday functioning does exist.
More Related Videos
06:04Author Spotlight: Studying Clinical Characters and Epilepsy Outcomes After Frontal Disconnection in Patients with MOGHE
Published on: August 16, 2024
09:57Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types: